Brent D Gunderson

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LPC-13840 Issued in AZ

Practice address

6718 E Calle la Paz Unit C
Tucson, AZ 85715-4093

Phone

(520) 270-2177

NPI assigned

Aug 13, 2018

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2006

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Masterdream LLC

  • Professional Counselor
  • Tucson, AZ
  • NPI 1225630528
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1534118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603843200000",
    "number": "1376022186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6718 E CALLE LA PAZ UNIT C",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857154093",
            "telephone_number": "520-270-2177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6718 E CALLE LA PAZ UNIT C",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857154093",
            "telephone_number": "520-270-2177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUNDERSON",
        "first_name": "BRENT",
        "middle_name": "D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-08-13",
        "last_updated": "2020-10-28",
        "certification_date": "2020-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AZ",
            "license": "LPC-13840",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Colleen Anne Gumm, NP
• Elisa Nicole Gumm, DO
• Heidi Anderson Gummel, COTA/L
• Tushara L Gunatilaka, DDS
• Kaleigh Gundersen, LPN
• Erika Gundrey, FNP-C
• Charlene A Gundry, NP-C
• Ahmet Gunkan, MD
• Dawn Ellen Gunter, M.D.
• Jennifer Suzanne Gunther, MD

• Mental Health Counselor in Tucson, AZ
• Providers in Tucson, AZ by specialty
• Mental Health Counselor in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.